Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 2018-01265 | NC |
Y | 207W00000X | Ophthalmologist | 72802-20 | WI |
NPI | 1003233255 |
---|---|
Provider Name | Kenneth Weinlander |
First Address | Milwaukee, WI 53203-2403 |
Second Address | Milwaukee, WI 53203-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 30/06/2020 |